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Home My WebLink AboutBuilding Permit # 3/28/2016 BUILDING PERMIT mo — TONIN OF NORTH ANDOVER ° A I APPLICATION FOR PLAN EXAMINATION ' Permit No: Date Receivedx a e --..... � +,.eo gyp"a5 Date Issued: 95SgcHuSFs PORTANT:Applicant must complete all items on this page LOCATION 2-0 MkL-L-ROAs > Print PROPERTY OWNER Ml/� ty RPi 1 1 Print' MAP NO: /i?lr PARCE06/0 ZONING DISTRICT: Historic District yesr�n o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential _ Non-Residential New Building One family jddition Two or more family Industrial ✓Alteration No.of units: Commercial Repair,replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer a fEi S-Ze7o o iy O wok L1 �r�T c�tJ K t rc�t��a A NC7 Ili tlJ fs F-C-Y:)ti w7no�t_L z 13%x Alm Zyi � N� n Ide^nt^ification Please Type or Print Clearly) `v\ OWNER: Name: M �\'k U#'3 } Phone: 7-E,•�--)57-- 656- Address: ZO L-L-ROAD IOI~TH Nz)c vg)=. CONTRACTOR Name: g 7 r Phone: Zv 6�iC31 C>A-NIEl— �JAli Address: �1 O I V\ " Supervisor's Construction License: Exp: Date: CSF=F1 Q`A-U62_E) Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED//C,,OST BASED ON$125.00 PER S.F. Total Project Cost:$ `� FEE:$ "Y Check No.: 5r6-T(' Receipt No.: 3o 1koo NOTE: Persons with unregistered contractors do not have access to ttt uaranty fund Signature of Agent/Owne � Signature of contractor c'�. -- Town of) ndover O M No. &&6 2120P h ver,Mass, "meq A0 RA7E0 S U BOARD OF HEALTH Food/Kitchen IT I L OLO I)" Septic System THIS CERTIFIES THAT........... BUILDING INSPECTOR ,1t s Foundation has permission to erect..........................buildings on............................! Rough to be occupied as. .1 .... ..� ....1�,•i•.. ...��..... ........��. ... Chimney provided that the person accepting this permit shalt in every respect conform to the terms of the application Final on file in this office,and to the provisions of the Godes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough J�/j Service ......................... .W ........................... Final BUILDING INSPECTOR GAS INSPECTOR '.. Occupancy Pertzzit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises—Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners.Seek legal advice if necessary.Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information'Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information Name Company Name MAS MUU",--1 _ �oF��teuc�tar-) co C. Street Address(do not use a Post Office B(A address) Contractor/Salesperson/Owner Name ;-?-c_M 1-LL- F_L�-- _ -- City/Town State Zip Code Business Address(must include a street address) M.0-R-11A UI be- 57 `H(D MA,1-3 Daytime Phone 'Evening Phane City/Town State Zip Code `>)_l5- g52 • E>s6leF __ C)ug- 3-1-Mailing Address(It different from above) Business Phone Federal Employer JD or S.S.Number Hpmelmprovm[em Contractor Rey.Number P.xpva[inn date taw r<amre,mat moa nomt rsh nn are��,nnn n�mn« 12.c'139�j-- g'Z-1'Z(z,1 'Che Contractor agrees to do the following work for the Homeowner: {Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,p_V additional sheets if nece�ar_v.) Oki<.1,.) �GT1a1J o� ujA'U- 8�cT1,��r� IL N7T 4r-`ytl AS,) > Required Permits-The following building permits we required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of 3�_? j 9atc when contractor will begin convected work. MGL chapter 142A.) �--::fi AIL-Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total scan of �._ M Payments will be made according to the following schedule: ......upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) by / / or upon completion of $ by / /_......or upon completion of_------ upon ___upon completion of the contract.(Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for ordered before the counseled work begins in order to meet the completion schedule.(**) $_ to be paid for_ NOTES:(*)Including all finance charges(")Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which most be special ordered in advance to meet the completion schedule. Express W tv Is an express a tv h'e provided by the contractur" c No❑Y (all tc ms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document„the contract shall not imply that any lien or other security interest has been placed on the residence.Review the following cautions and notices carefully before signing this contract. Don't be pressured into signing the contract.Take time to read and fully understand it.Ask questions if something is unclear. • Make sure the contractor has a valid Home Imnrovement Contractor ReeistrationI The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration.You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by catling 617-973-8787 or 888-283-3757. Does the contractor have insurance?Ask the Contractor for his insurance company information so that you can confirmcoverage,or ask to see a copy ofa"proof of insurance"document. • Know your rights and responsibilities.Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement.See the attached notice of cancellation form for mi explanation of this right. AO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! 7 idc,ecal copic,ofthe contract must be co pl t d ad signed,One copy should ge is the ho ne, be kept by me convector. Homeowners Signatt1f �� Contractor's Signature Date Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in Court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General L Homeowner's Signature Contractor's Signa flife— NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic Consumer rights. Ifyou have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract Must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in ajoint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website If you want to verify the registration of contractor or if yon have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website af,�—If Go online to view the status of a Home M5ent Contractor's Registration: For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734-3114 Version 2.1-11/22/2010 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION,WITHOUT PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE,IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED,ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE;OR YOU MAY,IF YOU WISH,COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION,YOU MAY RETAIN OR DESPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER,OR IF YOU AGREE 1-0 RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO,THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM TO[Narne of Seller],AT[Address of Seller's Place of Business]NOT LATER THAN MIDNIGHT OF (date). I HEREBY CANCEL THIS TRANSACTION. Date:-3.16 -Z-o LG Buyer's Signature:_______ � 1 � 4 LAWRENCE H OGDE d FZ r 198 EAST MAIN STREET GEORGE,rOWN,MA.01833 978-352-8318,se&@ 978-502-5921 ,f .._------- iTxtiv 'F=c v Wit ... n 7 v, L i / \-5T- -LILL ,a �� "o.c`. "I -7ijl� Lf G.a r „ 1 i s— IS '��OI3,suewp �9c eL6 �t-t zi.»t W qoy, sy cv a ry{c3 -aom� at'�Z'a3Gca n Ln— OKI LAW �D cmc,O Cl C`a 41-t"a Q� _'�-- /`�° cc3so�aa� ��'�c�3S�'a.syt7lc�rU�g i ca s�raacr�90 IE �tN CNV dttci®tt ca'�Q21-tom t Vet �`L V TO vast The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations l I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass,gov/dia Workers'Compensation Insurance Affidavit.Builders/Contractors/Electricians/PlumbersApplicant Information Please Print LeMbly Name(Business/Organization/Individual):'Tk4/f3 TI��p-"tM't ,�_Td o!-�--,&�C-_ Address: �10 NAA i F� — City/State/Zip:_G--FLCUELA43P W,, ( Phone 4: �� 3_ -7? Z� — --- Are y u an employer?Check the appropriate box: Type of project(required): 1. lam a employer with_ —' 4 E]I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers'comp.insurance comp•insurance.f required.] 5.❑ We are a corporation and its 10.❑Electrical repairs or additions 3.El am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. fight of exemption per MGL 12.❑Roof repairs insurance required.]'' c.152,§1(4),and we have no employees.[No workers' 13.❑Other_ comp.insurance required.] 'Any applicant that checks box 131 most also fill out the section below showing their workers'compensation policy information. Homeowners who submit this afifid.vit indicating drey ane doing all work and then hire outside contractors most submit a.new affidavit indicating such. `*Contractors that chuck this box most attached an additional sheet showing the nam of the sub-contractors and state whether or not those entities have. employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job site information. _ Insurance Company Name:_A-'_,-h�l�-tc_? �Lb -�? 711}4GV1_YCN��_ Policy#or Self-ins.Lic.#/:_W_CC,—` __k5 Expiration Date: Job Site Address: 7_0 M 1 U-?'OA- +!�L City/State/Zip:L�Q P__ AAF arr� "A Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL e.152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. do hereb cer r alties of perjury that the information provided above is true and correct. Sihnature: �r Date: (�' �b Phone#: L i 1 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6,Other Contact Person: Phone#: ti Ofgc00f Consumer Affsars A:T,1 eA ss frleg:aisti,�a: HOME IMPROVEMENT CONTRACTOR tf-"Y I Registration: 129395 Type: ' Expiration: :8/24/2017 Prival-I Corperaticn Talbot&Ryan Construction Co.,Inc Daniel Ryan 410 Main Street Groveland,MA 01834 Uaders mtiry Massachusetts Department of Public Safety Board.of Building Regulations and Standards License:CSFA-048628 Con 1 u ion S ioo visor 1 i{2 DANIEL K RYAN 410 MAIN ST GROVELAND MA 01834 ('"✓I�..�n �,_JS._. �xpirat,cn. Commissioner 0672812018